WASHINGTON - Civil liberties advocates caution that mandatory
vaccinations, forced quarantines and restricted interstate travel
would not only endanger individual rights but also would be unlikely
to prevent disease in the event of a severe H1N1 outbreak.

"These raise the highest
constitutional problems," said Michael Greenberger, director
of the Center for Health and Homeland Security at the University
of Maryland, at a recent panel discussion.

Sharon Bradford Franklin, senior
counsel at the Constitution Project, an advocacy organization
for civil rights, said it's important to consider the "potential
impact of individual rights" and the "legitimate scope
of government power" in the event of a flu pandemic.

Last month, an order that would
have required all New York State health workers to get the H1N1
vaccine created a public outcry. The mandate was rescinded after
state officials said the vaccine was in short supply, but the
issue of mandatory vaccination raises serious legal and constitutional
issues.

"You can't force someone
to get a vaccine you don't have," said Wendy Mariner, author
and professor of health law at Boston University.

Mariner said that new laws
imposing mandates in the event of a national emergency, such
as a severe flu pandemic, are unnecessary and often create public
backlash.

In 1918, a global flu pandemic
swept the world, killing more than 50 million people and infecting
500 million. A new strain of the H1N1 flu virus struck the United
States in April, leading President Barack Obama to declare a
national emergency.

"Today, we know a lot
more," said Dr. Marita Mike, health director at the University
of Maryland Center of Health and Homeland Security. "We
have medical capacity that we didn't have then."

But Mike said that, even though
medical advances have been made since the last flu pandemic,
another outbreak could cripple the population much as it did
in 1918.

The World Health Organization
reported 441,661 cases of infection and 5,712 deaths as of Oct.
25.

Federal quarantine has rarely
been used in public health emergencies. Large-scale isolation
and quarantine was last enforced during the flu pandemic of 1918-19,
according to the Centers for Disease Control and Prevention.
Since then, the CDC has reported only two incidents of quarantine
and isolation. In 1963, a federal quarantine order was given
to a person with a suspected case of smallpox. In 2007, an airplane
passenger with a rare, drug-resistant form of tuberculosis was
put in isolation.

Greenberger said a severe outbreak
of H1N1 isn't likely, but in the case of a pandemic, state and
federal governments have extensive executive emergency powers.
State laws give governors the authority to contravene any law
that interferes with the governor's ability to deal with an emergency.
Most governors have the power to take drastic measures such as
quarantining people, seizing medications, overturning laws and
using martial police power.

"Just because a governor
has these extraordinary powers does not mean a governor will
use those extraordinary powers," Greenberger said. In fact,
a governor has never used such powers in a public health emergency
-- but they have used them in floods and hurricanes.

Mariner said she doesn't think
these types of measures or emergency preparedness laws can prevent
disease, and she critiqued the post-9/11 mentality of coercive
public health tools that threaten individual civil liberties.
Instead, she said the best defense against a flu pandemic is
a "healthy, resilient population."

Instead of relying on emergency
laws, Mariner said the government should focus on education,
vaccines and access to health care.